Friday, June 28, 2013

Hyperbaric: a short review

A new machine sits in my office and I have just finished setting it up:  a portable, low pressure hyperbaric oxygen chamber.

There are three types of chambers:  standard, hardened chambers (mono-place)  which can deliver high pressures with 100% oxygen, multi-place chambers can deliver high pressure to several patients at the same time and require external oxygen and low-pressure, portable chambers which use external oxygen and must be inflated. 

Hard chambers have a history of treating many acute and serious medical problems, including:  air embolism, decompression sickness (altitude sickness), gas gangrene, crush injuries, carbon monoxide poisoning, necrotizing fasciitis, osteomyelitis, non-healing diabetic ulcers and more.

Low pressure chambers are newer on the market.  Both types of chambers have been used for the treatment of Lyme disease ( anecdotal information only).

There are numerous other conditions treated with low pressure hyperbaric therapy including:  autism, migraine, fibromyalgia, chronic fatigue syndrome, traumatic brain injury and too many to list.

In either case, patients must have daily therapy for several months, at least 2 months. The therapy is ineffective if used sporadically; so starting hyperbaric therapy, with each session typically lasting one hour, is quite a commitment. The treatment is generally used as an adjunct to antibiotic and/or other therapy.

Some benefits of treatment are:  improvement of immune function; antibiotic effects; selectively kills anaerobic bacteria including Lyme; improves the penetration of antibiotics;  is able to reach areas where Lyme hide because of limited blood flow, such as cartilage; leads to formation of oxygen free radicles which kill bacteria, constricts blood vessels while delivering more oxygen and therefore swelling, a byproduct of the inflammation which accompanies Lyme, has good penetration in the brain (blood brain barrier not a factor), quickens the healing of damaged tissues, improves fatigue and stamina, increased brain function has been documented in SPECT scans, including low pressure therapy and most elite athletes use them (low pressure)  because it enhances performance and decreases healing time.  There is some literatue to support the contention that low pressure is more effective than high pressure for certain conditions, including traumatic brain injury; many other benefits are reported as well.

Pressure is measured relative to pressure the atmosphere exerts on our bodies at see level.  The pressures are called ATA, absolute atmospheric pressure.  Low pressure therapy ranges for 1.3 to slightly higher than 1.5 whereas high pressure ranges to about 3. Pressure is for example what your body experiences when you swim underwater:  1.3 ATA is equivalent to swimming 11 feet underwater. Both camps claim effectiveness of their therapy.

A big difference is cost.  High pressure HBO is very expensive and may typically range from 200-250(or more) dollars per treatment.  Low pressure HBO therapy is typically offered in the range of 75-150 dollars per treatment. Discounts may be given when patients sign up for more treatments. For example, a 20 day course of therapy offered in a hard chamber clinic may cost about $3,600 while the same course of treatment may be offered at $1400 in a soft chamber clinic.  Another advantage of low pressure treatment is that serious side effects are virtually absent.

Another very significant advantage of low pressure devices is that these devices may be rented or purchased for home use with a doctor's prescription.



4 comments:

Jared said...

Doctor, would you be willing to write a new post on the relationship of gallbladder and lyme patients. Have you found any treatments to be successful that can prevent surgery? How do patients do after surgery?

Thank you for your time.

Jared

Lobkowicz, Philip said...

Can you provide anecdotal information on how low pressure HBO has helped lyme patients please. To date, I have only heard anecdotal information that high pressure HBO has at times worked.

Mary O'Donnell said...

Are you planning on using this chamber? On yourself or a patient? I, too have heard that a higher pressure is needed for treatment of Lyme disease.

Curtis said...

Does the hyperbaric treatment have to be done every day because the clinics I've called are usually only open either monday-friday or sometimes only 3 days a week?